Personal music may ease swallowing issues for people with advanced dementia, according to a 2018 study published in Dementia: The International Journal of Social Research and Practice. Promising results reported in the pilot study, conducted at Columbia Health Care Center in Wyocena, Wisc., in collaboration with Music & Memory and researchers at Stony Brook University, indicate that personal music has the potential to improve food intake, nutrition and hydration at a critical point in the disease process.

Five years ago, Columbia Health Care Center was one of the first nursing homes in Wisconsin to become a MUSIC & MEMORY® Certified Care Organization. In 2015, staff recommended using the personal music program as a Quality Assurance (QA) initiative, to explore how it could best benefit residents and the care environment. Since progressive dementia can make swallowing more difficult (dysphagia), causing reduced ability to eat and resultant weight loss, the QA team decided to explore whether listening to personal music could possibly ease dysphagia and related eating problems.

Over three months, an interdisciplinary clinical team tracked resident food intake following use of personalized playlists a half-hour prior to dinner. The study focused on five residents with the greatest difficulty swallowing or feeding themselves. (One was eventually eliminated from the study due to overstimulation from listening to the playlist.)

Results were encouraging. Average food intake for the four subjects without the Music & Memory intervention was 41.4 percent; when personalized playlists preceded supper, the average food intake increased to 71.4 percent, a statistically significant change. Among the team’s observations, swallowing and nutritional status improved, while choking incidents during mealtime declined. In addition, the subjects’ weight stabilized and they had less need for speech interventions or thickened liquids. Overall quality of life was enhanced.

While the sample size was small, the results are encouraging, says lead researcher Stephen Post, PhD, Director of the Center for Medical Humanities, Compassionate Care and Bioethics at Stony Brook University School of Medicine. “Personal music is more than just a matter of bringing people a little bit closer to who they are for a period of time,” he says. “The pilot study actually suggests there can be a real, functional, physiological outcome.”

Although a decline in eating and ability to eat is a natural part of advanced dementia, using personal music to facilitate swallowing before the disease reaches a terminal phase could potentially enable the individual to enjoy eating and maintain weight for a longer period of time.

Help with Swallowing Enhances Quality of Life for the Individual, Family and Caregivers

Using personal music a half-hour before dinner to help the individual to relax and have an easier time swallowing, self-feed, if possible, and avoid choking has other benefits, as well. Music & Memory’s Robin Lombardo, Northeast Regional Director and a study co-author, says that for a person in an assisted living memory care unit, for example, choking episodes may tip the scales toward a move to a more enhanced care environment, such as a nursing home. That can be a traumatic experience for the resident, triggering anxiety and other complications.

Weight loss and choking issues are, understandably, red flags for any care organization. “Being able to prevent that from happening, or postpone the inevitable, enhances the individual’s quality of life and time spent with family,” she says.

“People do panic when someone they love is not taking much in,” agrees Post. For both caregivers who assist with oral feedings and family members, an intervention that helps ease the stress of mealtimes can be a huge boost.

All too often, he notes, the alternative to dysphagia in people with advanced dementia is a feeding tube—or Percutaneous Endoscopic Gastrostomy (PEG) tube—which is inserted into the abdominal wall to pass nutrition, fluids and medication directly into the stomach. While this may be medically necessary for certain individuals, there are significant downsides, including risk of infection and aspirational pneumonia. Individuals with dementia who have PEG tubes may be put in restraints to keep them from pulling out the tube, which presents a source of confusion. In addition, the feeding tube reduces the stimulation of eating and interpersonal relationships so integral to assisted oral feeding.

The pilot study’s encouraging results are attracting attention of nursing departments in other MUSIC & MEMORY ® Certified Care Organizations that want to see if they can replicate the Columbia findings, according to Robin Lombardo. A large scale controlled research study is “logistically complex,” says Post, but would be the logical next step to clarify outcomes and define best practices.

“I’d like to get to a point where no feeding PEGS are used on people with dementia,” he says. “It’s important to think about the quality of life for a person with dementia. When you put a bolus of food into their stomach, the stimulus of eating is lost as well as a relationship at a deep, ritualistic level. If you have oral feeding available, the person will probably do pretty well for a while before fading away. If Music & Memory can make this alternative more plausible and easier to manage, that’s a big advantage.”

Founded in 2010, MUSIC & MEMORY® is a non-profit organization that brings personalized music into the lives of people with cognitive or physical conditions through digital music technology, vastly improving quality of life.

We profiled Ginny Hauser, a devoted volunteer in Pullman, Washington, in 2015. Here’s an update on how MUSIC & MEMORY® is helping to ease transitions of care on the Palouse.

Ginny Hauser shares a personal music playlist with a resident at Avalon Care Center.

In 2013, when recently retired Ginny Hauser began training as a patient support volunteer at Pullman Regional Hospital, her class went to a screening of Alive Inside. That experience inspired her to ask if personal music could become part of her volunteer work with patients. The answer was yes, and MUSIC & MEMORY® on the Palouse was born the following December.

Today, Ginny is the lynchpin of a model program in southeastern Washington State that brings personal music to individuals as they transition through stages of care in the Palouse region. Participating Certified MUSIC & MEMORY® Care Organizations include Pullman Regional Hospital, serving the city of 31,000 and surrounding rural community; Avalon Care Center, a skilled nursing facility; Circles of Caring Adult Day Services; and Friends of Hospice, which supports those at end-of-life or living with chronic health conditions in private homes and adult family homes.

A music lover who plays the flute and sings in a choir for people in hospice, Ginny serves as volunteer coordinator for MUSIC & MEMORY® on the Palouse as well as a volunteer at all of the care settings, bringing personalized playlists to individuals wherever she goes. She derives deep satisfaction from seeing hundreds of people benefit from the power of personal music over the past four years. “Music is so important to me in my life, it touches my heart,” she says. “That I can help someone else by giving them music is so valuable.”

Tailoring Playlists to Individuals and Care Settings

To efficiently cover such a broad range of organizations across a rural region, Ginny works closely with staff at the various care settings. “All of our equipment is in heavy and continued use,” she notes. Each resident who enters Avalon Care Center is offered the option to have personalized music. Ginny creates the playlist that Avalon staff then introduce to the resident. She also creates tailored playlists that staff use daily for every participant at Circles of Caring.

Friends of Hospice has its own music devices and speakers, as well as a staff member who helps to set up the playlists on equipment that Ginny delivers to patients around the county. She has created Comfort Music playlists for patients who are anxious, in pain or near end-of-life, benefiting the individual, as well as family and staff. She also co-facilitates twice-monthly Rural Resources support groups for caregivers at home and helps them to develop playlists for their family members, using equipment from Friends of Hospice.

Inspired by the Power of Music to Bring Joy and Ease Pain

Watching people light up with smiles as they hear their musical favorites keeps Ginny invested in her intense volunteer commitment. She recalls the words of a longtime Avalon resident who has two music devices, one to listen to while the other charges: “Music is really soothing. It calms me down. The songs I like make me happy.”

Or the story told by an Avalon caregiver of a longtime resident: “When you put her headset on and play her music, she lights up, sings and dances in her wheelchair. She is happier, her cognition improves, and she engages with people and her surroundings. The music brings her out of her shell. She loves to hum along and sing the lyrics.”

Ginny notes that, at the request of an occupational therapist, she has created playlists for Avalon’s therapy gym that help patients feel more comfortable doing their exercises. “The tempo and beat of the music can help with gait work,” she adds. At Circles of Caring, which serves people with dementia and other cognitive conditions, staff praise the program for the way favorite music provides respite from agitation and comforts individuals who are having a rough day.

“Many of our patients are able to continue having access to their music as they move within the various care settings on the Palouse,” adds Ginny. Several families were so inspired by the experience that they asked her how to continue the music at home. At her suggestion, family members purchased a digital music device and rechargeable speaker. “I gave them each a list of their loved one’s music and talked them through how to re-create the playlist at home,” she says. In subsequent conversations, “I heard from each that their dear one was continuing to enjoy music and that they were so thankful that they could do something that would have a positive response.”

Building an Integrated Approach to Transitions of Care

For other communities considering such an integrated approach, Ginny has a few suggestions:

Public libraries can be a key setting for Music & Memory community outreach. Depending on available resources, she notes that they might need to limit participation to hospice patients, those with terminal health diagnoses, or other long-term health situations that impact quality of life, before offering services to the general public. Libraries are ideally suited to apply for grants and donations, and to widely publicize the program. They also often have a loyal corps of volunteers.

To provide continuity of care as an individual transitions from one care setting to another and possibly back home, social work staff can play an essential role, communicating with the next placement setting about the person’s need to access personal music. This communication would identify musical favorites and whether the person prefers a headset or speaker. Once personal music is added to the individual’s care plan, the playlist could follow them from one care setting to the next.

Founded in 2010, MUSIC & MEMORY® is a non-profit organization that brings personalized music into the lives of people with cognitive or physical conditions through digital music technology, vastly improving quality of life.

It was one of those challenging days at a nursing home near Indianapolis. A resident with late stage dementia was agitated, trying to get up from his seat and walk, although he was at risk of falling. Tending to him, nursing staff were unable to spend time with other residents and complete work that had to be done. Everyone was stressed.

That’s when speech language pathologist Natalie Scott pulled out a digital music device and began playing some of the man’s favorite music. “I was covering for another therapist, trying to work on verbal expression,” she recalls. “He was able to sit in his recliner and listen. When I turned off the music, within a minute or so, he said, ‘I was listening to that.’ The nurse told me she had never heard him speak before.”

As Natalie shared online images with the resident, she soon discovered that he was a retired fire chief. After viewing pictures of fire trucks and other equipment, he told her he wanted to get his fire hat. “It was a really great session,” says Natalie. “And the CNA’s and nurses were able to finish lunch with the other residents and distribute meds. It was pretty amazing.”

That experience inspired Natalie and physical therapist Jan Bays to team up and promote Music & Memory’s personalized playlist program to support a range of therapeutic applications, including physical therapy (PT), occupational therapy (OT) and speech language pathology (SLP).

“Music & Memory helps set up the person to do the therapy task successfully,” says Jan, now Director of Program Development and Education for Jill’s House in Bloomington, Indiana. “It makes the garden fertile.”

For example, when someone with a hand problem sees an occupational therapist, they may experience a lot of frustration and pain, trying to get their hands to move once again or regain strength, coordination and range of motion, explains Jan. Listening to their favorite music can help to distract them from discomfort and stay motivated.

The same holds for physical therapy. “One of the first successes that we had involved a person who really needed to work on repetitive exercises on an exercise bike, to increase range of motion and aerobic capacity” she says. “The therapist just couldn’t get them to do it for even five minutes. We put on the personalized music and they did it for 15 or 20 minutes.”

For elders with dementia or other cognitive impairments, says Natalie, personalized playlists can be used to arouse attention and help with self-feeding: “As someone is more alert and able to self-feed, it also directly reduces the risk of swallowing difficulty, because they are better able to self-monitor.”

There are many more ways to enhance therapy with personalized playlists. For example, playing the individual’s favorite music 15 minutes before a therapeutic session, such as personal care training for Activities of Daily Living (ADLs), can be invigorating and increase alertness and attentiveness to the task. Jan adds that when the person is depressed and even less willing to participate in therapy, that special music can give them a “big dopamine dump,” which boosts their involvement.

Together, Jan and Natalie offer a two-day webinar through Music & Memory, specially designed for PT, OT and SLP therapy applications. Therapists who work in a MUSIC & MEMORY® Certified Care Organization are eligible for the training; once they have completed the webinars, they can introduce the program to other MUSIC & MEMORY® Certified Care Organizations where they consult. The webinars explain Music & Memory’s particular benefits for these therapies; specific applications for people with dementia, medical complexities and those in short term rehab; as well as the nuts and bolts of documentation, billing and program development.

Building Quality Relationships with Personalized Playlists

In addition to improving patients’ attention and willingness to perform tasks, personalized playlists can help therapists to build the quality personal relationships that are so essential to a successful outcome. Favorite music “helps to make that connection with skills that are old and already known,” says Jan. “It’s helping the person attend to the past. It’s helping the person to find the energy and attention to relate. You have to make that connection and create a relationship before you can effectively teach. Therapists are invading people’s personal spaces, and you have to have a relationship with someone to successfully invade their space. Personalized music is a great way to do that.”

Therapists and their patients aren’t the only ones to benefit. Family members do, too. “It’s very common when family visit someone with a cognitive impairment, they don’t know what to say or do,” says Natalie. Sharing a personalized playlist can help to bridge that gap: “I can come up with a functional communication task to help communicate with their family member, to facilitate automatic verbalizations, the ability to appropriately engage and communicate.”

For caregivers, personalized music is also an important tool. Therapy, explains Jan, has three major goals: to restore function, to teach compensatory strategies for functions that can’t be performed in their customary way, and to adapt the person’s environment for success. Educating caregivers how to use personalized playlists at home to enhance the patient’s follow-through with therapy can reap huge benefits for all involved. “Music & Memory is a big way to adapt the person’s environment,” she says.

“What we have to do, especially for people living with dementia, is to give them an environment in which they feel competent,” says Jan. “They know who they are and they know what to do. Music & Memory makes that connection to a time when the person was competent and they felt comfortable.”

Founded in 2010, MUSIC & MEMORY® is a non-profit organization that brings personalized music into the lives of people with cognitive or physical conditions through digital music technology, vastly improving quality of life.

Inspired by the power of personalized music, Anne Brazil has decided to include Music & Memory in her will.

Anne Brazil was surfing Netflix one day when she discovered a video that moved her so profoundly, she had to act. The video was Alive Inside: A Story of Music and Memory.

“I admire how Dan Cohen has not only improved the quality of life of many lonely souls, but literally sparked their long-lost vitality,” says Anne. “He takes a simple iPod loaded with music to a nursing home, places the headphones on the patient, and something magic happens. No pills, no shots, no surgery, nothing invasive, just a simple, loving gift of music, and the person is miraculously changed. Eyes pop open, a smile appears, hands wave and toes tap.”

For this former music teacher with a Master of Social Work, the concept was captivating. “What can I do to support this remarkable program?” she wondered.

A Bequest for MUSIC & MEMORY®

Anne mailed a check to Music & Memory, asking only that it be used however her donation could make the greatest impact. In response, she received a personal thank you card from Dan. “He didn’t flood my email with pleas for more, and he didn’t stuff my snail mail box, either,” she says. “This program is a cut above.” As she learned more about the organization’s efforts to spread the power of personalized music, Anne considered dedicating a portion of her estate to Music & Memory.

“For years I was just a teacher on a salary with a kid,” she explains, as she scans the Pacific Ocean from her home in Cayucos, a small fishing village about two hours north of Santa Barbara. ““I squirreled away every refund, every bonus, every royalty. When I had saved enough, I picked up another house or apartment. Soon I traded up to larger properties to build my holdings. Finally, I was able to take the leap to California’s beautiful central coast. I’m really blessed.”

Sharing the Healing Power of Music

A California native who grew up on a farm, Anne first learned to play the clarinet in school and later, many other instruments. (Her musical favorites include Gregorian chants, Mozart, Leonard Cohen, the Three Tenors, the Pentatonix, and Rock ‘n Roll.) After earning a degree in music, she taught beginning instruments, then branched out to vocal and instrumental instruction at all school levels over her 40-year career.

“Music changed my brain, too,” she says. “It repaired the broken synapses of words and reading. It led me out of the shame of dyslexia. I was able to achieve success academically and professionally, thanks to the healing power of music.”

World travels included teaching gigs in Japan, Germany and Portugal. In midlife, when a teaching promotion fell through, Anne decided to broaden her professional credentials and went back to university to earn a Master of Social Work: “I didn’t change careers after all, but relocated from farm country to the beach, to share my music with little surfers and sun worshippers.”

Time to Give Back

Now retired and enjoying the fruits of her careful saving and investments, Anne decided it was time to give back. “I’m a senior citizen myself,” she says. “I’m fortunate to have the means to last my remaining years. All my needs are met and almost all my wishes. It was time to put my desires on paper.” In the process of drafting her will, she decided to include Music & Memory as a beneficiary.

“My quality of life is ample,” she says. “But I realized there are some older people who are really suffering. They’re locked inside themselves. If we can give someone another year or even a month of fun, we should do it—with a smile and a laugh and love!

“I’m leaving this world with empty hands, anyway, so why not endow a portion of my estate to Music & Memory, where it will help to restore vigor to so many? We are here to help each other. That is my purpose.”

Founded in 2010, MUSIC & MEMORY® is a non-profit organization that brings personalized music into the lives of people with cognitive or physical conditions through digital music technology, vastly improving quality of life.

Manon Bruinsma directs Music & Memory in the Netherlands and guides international expansion.

It all began in 2008 as an experiment with a handful of residents in four New York nursing homes. In the ten years since, MUSIC & MEMORY® has brought the power of personalized music to every state in the U.S., as well as Canada, Australia, Europe, the Caribbean, Israel and South Africa. And pilot programs are underway in Japan.

Shepherding Music & Memory’s international expansion is Manon Bruinsma, a music therapist based in the Netherlands, who first heard of the program when she viewed the Henry video online. “People kept sending it to me and telling me this is going to be your thing!” she says. “It struck me like lightening.”

That was just the beginning of what has become a passionate life’s journey to bring the benefits of personalized music to her home country, as well as the rest of Europe and beyond.

Launching International Expansion from the Netherlands

Manon’s first step was to contact Executive Director Dan Cohen, who put her in touch with another Dutch music therapist. Together, they took Music & Memory’s training and began to set up personalized playlists for some of their clients—and learned a few lessons. “I thought the headphones would be isolating,” she says. “And I thought people who were musical all their lives would respond the most positively, while people who had no musical involvement would not.” Both assumptions proved to be false.

Intrigued by how Music & Memory was improving quality of life in nursing homes where she worked, Manon volunteered to field questions about the program from people outside the U.S. She also continued to advance the use of personalized playlists at nursing homes in the Netherlands. Then, in April 2015, she traveled to New York City to meet with Dan and formalize the founding of Music & Memory in the Netherlands; in addition, Dan asked Manon to direct the organization’s European outreach efforts.

That role has vastly expanded to encompass the rest of Europe and Quebec. Today, there are 48 MUSIC & MEMORY® Certified Care Organizations in the Netherlands, including two on the Dutch Caribbean island of Curaçao. Manon has also helped to train care professionals in Quebec, the United Kingdom, Germany and Switzerland—she speaks Dutch, English, German and French.

Beyond Europe, five nursing homes in Israel are running pilot programs. Two nursing homes in Japan are also running pilots. Then there is Our Parents Home in South Africa, Music & Memory’s first site on the African continent.

Through other partnerships, there are more than a hundred MUSIC & MEMORY® Certified Care Organizations throughout Australia and nearly 300 in Canada. And the inquiries keep coming—from Hungary, Denmark, Sweden, Austria, France, Italy, Poland, Portugal, Spain and Argentina. Research about the benefits and impact of personalized music is underway at universities in the Netherlands, Germany and Poland.

Cross Cultural Differences and Similarities in Caring for Elders

Keeping on top of it all is certainly a challenge. Manon travels across Europe to bring in-person training to new countries—first testing out translated materials and adjusting for cultural nuances in one key nursing home before expanding online training to other care communities in that country. “I feel like I have to scale up on a monthly basis,” she says. “But it’s hugely rewarding. When nursing homes at the forefront of dementia care adopt the program, it spreads from there.”

The experience has highlighted cross-cultural similarities in elder care, as well as some striking differences. Budgets are being cut everywhere, Manon observes. High staff turnover is a persistent challenge, in part, she believes, because many countries are trying to keep people at home longer. By the time they are placed in a nursing home, they are much sicker, creating more stress for staff.

But, she adds, quality of care differs greatly from country to country, depending on tax revenues and the degree to which each government is involved in running the homes. In the Netherlands, for example, almost all nursing homes are publicly owned; compulsory public long-term-care insurance supports a high standard of care. In the U.K., by comparison, 70 percent of the homes are private. France requires families to be involved in their family member’s care, including bringing food, to get a placement.

Emphasis on Keeping People at Home as Long as Possible

Across Europe, she sees a trend toward favoring home care over nursing homes. As Music & Memory develops new training for home care agencies here in the U.S., the demand for parallel training for European countries, as well as family caregivers, will undoubtedly increase.

Manon’s big dream, to help meet the need, is to partner wealthier Northern European countries with Southern European countries that have fewer resources. “I had a call from someone in Hungary who wants to get Music & Memory running in their town, but its too expensive,” she says. “I would love to get a country like Denmark or Sweden to be their sponsor.”

Whatever the hurdles, Manon finds the work of Music & Memory’s international expansion to be deeply rewarding. “The greatest thing is always getting a video or picture about how well it works, how it’s changing lives of so many people,” she says. “The way that people respond to music is universal. People ask me if I miss the one-on-one contact as a music therapist, but every time I hear a story that this worked, it’s worth it. Music & Memory has widened my world.”

Founded in 2010, MUSIC & MEMORY® is a non-profit organization that brings personalized music into the lives of people with cognitive or physical conditions through digital music technology, vastly improving quality of life.

Carol Ann Jones chats with an audience member after a Power of Music performance.

John was nearing the end of his life, no longer able to speak, when Carol Ann Jones brought her guitar to his bedside at a Vermont nursing home for another visit. She began to strum one of his favorite songs, Me and Bobby McGee. John’s brothers were there, and one joined in with his harmonica. Everyone sang. John’s eyes opened wide.

“There was so much love in that room,” says Carol Ann. “You could see his body relax. You could see the joy in his eyes. He lifted his arms up and was waving to the music. When I got to the end of the song, all of a sudden all these voices joined me. He was waving people into the room—nurses, the chaplain. It was incredible.”

Not long after, John died on Thanksgiving weekend. His wife called to thank Carol Ann for all her musical visits to his bedside. She attended his funeral. The experience inspired her to write his story in a new journal—the first of many stories of the hospice patients she played for at Saint Albans Healthcare and Rehabilitation Center. By the time the journal was full, she had written about more than 180 people’s end-of-life journeys.

Raising Awareness and Funds for MUSIC & MEMORY®

An award-winning recreation assistant at Saint Albans who loves to play her guitar and sing for the residents, Carol Ann also helped to launch the 85-bed care community’s Music & Memory program. She creates and updates personalized playlists for people in the memory care unit and runs bake sales and other fundraisers that have enabled Saint Albans to acquire 15 digital music devices. Inspired by a screening of Alive Inside, she volunteers her time for administering the program, in addition to her part-time paid work in recreation therapy.

Now Carol Ann has put her love of playing live music for residents and her experiences with hospice patients toward a new musical endeavor to raise money for Music & Memory and spread awareness of the personalized music program throughout Vermont. Inspired by a friend who loved the stories in her journal, she decided to write a one woman play based on 12 of the most interesting people she had met and sang for.

“The story of John is the first one,” she says. “Then I play a couple of his favorites, Bobby McGee and Red River Valley. Then I go on to the next one, a very different story and music. There’s a wide variety.” At each performance, she includes a display of literature about Music & Memory and Alzheimer’s, as well as a box to collect digital music devices.

After her debut in Saint Albans last July, people encouraged her to take her show on the road. “I’m going to do every county in Vermont,” says Carol Ann, thanks to a $5,000 donation to Music & Memory from an enthusiastic member of the Saint Albans audience. At each stop, she makes a point to connect with the local home hospice agency and collect digital music devices for the nearest MUSIC & MEMORY® Certified Care Organization.

Building Personal Connections Through Beloved Songs

In addition to her Music & Memory road show, Carol Ann performs folksong singalongs at care communities around the state, as well her own show at area coffee houses. She also runs half marathons. A former accountant, she keeps the books for the family dairy farm. Even as the competitive organic milk market forced Carol Ann and her husband to make tough decisions about selling their dairy herd last June, she credits her husband with encouraging her to stick with her music.

What keeps her going—both playing for residents and promoting Music & Memory—is the personal connections she builds through beloved songs. “It’s the joy, the pure, simple joy that you can bring. The awakening that happens,” says Carol Ann. “It turns people around from being so lost and so confused and sad to, ‘Hey, I’m with you!’ It doesn’t matter where we are, we’ve connected and we have this music, this sharing going on. It’s just priceless.”

Founded in 2010, MUSIC & MEMORY® is a non-profit organization that brings personalized music into the lives of people with cognitive or physical conditions through digital music technology, vastly improving quality of life.

Oneida Long Term Care residents can travel the virtual world with digital tablets.

Oneida County Long Term Care may have only 32 beds, but that hasn’t stopped Cindy Dawson from dreaming big. In charge of medical data systems for the small skilled nursing facility, located 13 miles north of the Utah border in Malad, Idaho, Cindy wanted to take a giant step beyond Oneida’s MUSIC & MEMORY® personalized music program to bring other forms of technology-based mental and emotional stimulation to residents.

So, she applied for a $50,000 CMP grant to expand access to technology. Her case was clearly persuasive, because the full request was awarded in January 2016, enabling Oneida to purchase smart TVs for every room, even a digital baby grand piano, among other items, as well as a new wireless network for their residential building. How did she pull off such a large grant for such a small care setting? “Because I said I could,” says Cindy.

Thanks to her efforts, Oneida also received a grant from Music & Memory for several digital tablets in April 2016. In addition, they participated this past summer in a Music & Memory pilot program to test digital tablet applications in nursing homes, funded by a generous grant from the Consumer Technology Association Foundation (CTAF).

Making Connections Around the World

That can-do attitude has enabled Oneida residents to regain a sense of personal agency. Tablets have reopened a window to the world via the Internet. One resident, a Native American man originally from New Mexico, listens to Navajo news and virtually attends powwows. Another resident was able to participate in a funeral for her twin sister via Skype. A third, who is 102, uses her tablet to shop with money that her son gives her on a debit card; recently she purchased a wedding gift for family in England.

The tablets have also provided an important intervention for individuals with dementia. “If someone has problems remembering things or is in the middle of an ‘escape,’ trying to leave the facility, we’ll take it to them and say, ‘Oh, look at this,’ whatever their favorite thing is,” says Cindy. The distraction can calm and redirect the individual.

Other residents use the tablets to listen to music, or to virtually attend religious services or conferences. Some volunteers whom Cindy trains to conduct oral histories have used the tablets to collect family information and upload details as well as scanned photos to oral history websites.

Meeting Individuals “Where They’re At”

That’s not to say that every resident at Oneida wants access to a tablet. Says Cindy, “We meet them where they’re at.” For some, that means listening to music on a cassette; for others, using a CD player. But experience has taught her that everyone can adapt to new technology at their own pace.

Digital music devices loaded with personalized playlists remain popular, with powerful results. One resident, who was totally uncommunicative, came to Oneida heavily medicated on five drugs. Cindy was convinced that the medications were affecting her behavior and worked with staff to reduce them, while offering her a personalized playlist. The woman is now down to reduced dosage on one medication, and Cindy expects her to no longer need it at all.

“She now turns her head, she’s not in that catatonic state any more, she participates with others,” says Cindy. “If she sees someone using a tablet, she’ll sit down and use it. She runs around with an iPod, listening to her music. She will actually come to me and ask for it.”

Culture Shift for Staff, Too

Residents can attend events, speak face-to-face with distant family or friends, visit favorite places, learn more and feel a stronger connection to the outside world.

Staff have certainly noticed the benefits. Where once they were wary of the new technology, Cindy says more are coming to her with requests: “They’ll say, ‘Oh my gosh, what can I do? I need some technology. Give it to me now!’”

In addition, the technology’s visible benefits have inspired about a half-dozen families to buy tablets for their family members, and two residents now own their own laptops.

“We’re using technology everywhere you turn,” says Cindy. Innovations include smart TVs in every room (most are doubles) that are loaded with roommates’ individual playlists and family photos, so that each can watch a personalized music slideshow on the TV. There are also smart TVs for the day room, family room and hallways, all with Internet access. Programming includes images from around the world accompanied by calming music, YouTube videos, and individual’s playlists, which are stored on thumb drives. Residents use wireless headsets to avoid accidents with tangled cords.

“This Is Their Home”

Facility-wide, the new technology has been transformative. “There’s been a massive change,” says Cindy, who has worked at Oneida since 2000. “We went from no-one participating in activities to everyone fighting over participating in activities. Our residents are so empowered that they make their own schedules.”

The technology has also deepened relationships among the residents themselves. “Residents reach out and include each other in the experience of technology,” she says. “They laugh, joke, dance and even compare hard times. It’s helped to build friendships in an unexpected way.”

These shifts are in keeping with leadership’s belief that residents should feel at home at Oneida.
“This is their home,” says Cindy. “They get to do what they want.”

Personalized playlists were the first step toward empowerment. “Tablets open up a huge world,” adds Cindy. “Technology makes them feel that they can still do things, and when you can still do things, you can still learn things, your mind is still stimulated. Because you’re stimulated, you start taking control of your life. You have initiative.

“They’re not left out anymore.”

Founded in 2010, MUSIC & MEMORY® is a non-profit organization that brings personalized music into the lives of people with cognitive or physical conditions through digital music technology, vastly improving quality of life.

The 17-bed Special Care Unit at the Idaho State Veterans Home is always full. “It’s an alpha male environment,” says Oni Kinberg, LCSW, Director of Social Work for the Boise veterans care community. The residents tend to be combat-trained World War II and Korean vets, some with significant dementia who don’t respond to much around them.

That’s where Music & Memory fits in. Oni recalls one vet, a man who had served on a submarine and had also sustained football head injuries in his youth; he barely reacted to his surroundings. His wife was his high school sweetheart, and she knew how much he loved Johnny Cash. So Oni set up a playlist and gave him an iPod with headphones.

“He’d tap his feet,” says Oni. “When we’d take the headphones off, we noticed that he was listening to the music playing in the background. He’d start singing. Having his own playlist stimulated him to be more alert. Even the staff were surprised. They’d tell me ‘Oni, he’s listening to music!’”

The vet died a few months later. But Oni has no doubt that the Johnny Cash playlist enhanced his quality of life to the end. He’s seen plenty of evidence in the three years since the Idaho State Veterans Home became the first long-term care community in the state to earn MUSIC & MEMORY® Certification. Active in the statewide ICARE coalition, a network of about 90 Idaho nursing homes, Oni promotes Music & Memory as a highly effective way to foster person-centered care.

Relaxation and Respite for Veterans

Memory care units, long-term care communities and hospitals that serve veterans face a unique mix of challenges. Populations are predominantly male, many of whom have experienced war firsthand. Depression, PTSD, alcohol and drug dependency, and other mental health conditions occur at a higher rate than among the general population. Personalized music playlists can help the veterans to relax and find a welcome, peaceful respite.

For those in veterans hospitals, Music & Memory can help to make an institutional stay feel more personal. “We have a lot of veterans in our hospital who are waiting a year for placement,” says Anne Johnson, LCSW, Caregiver Support Coordinator at the San Francisco VA Medical Center. “Many have dementia and need a nursing home that will accept residents with behavioral Issues. So our inpatient service Is trying to find ways to improve the lives of folks who are stuck here.”

Many Adaptations in Veterans Care Settings

In addition to her full-time responsibilities, Anne volunteers in the Social Work Department to bring Music & Memory to patients. She draws on two years of experience with the personalized music program, based on her work at her previous position at the San Francisco VA Community Living Center. There she learned how beloved music can play an important role in palliative care, an adaptation she has introduced to the VA Medical Center.

She recalls the case of a patient who adored classical music. “His wife told me that her husband needed Mozart,” says Anne. His favorites included the string quartets and The Marriage of Figaro. She loaded the music onto an iPod and hooked it up to a speaker in his room. “He died listening to Mozart. It was a much better death. The staff relaxed, too.”

At the Idaho State Veterans Home, Oni Kinberg has used personalized playlists as well as classical music on speakers to improve the dining room experience. A noisy, restive environment during meals was causing some residents to avoid mealtime. “When people are listening to their own headphones or classical music on the speakers, it’s a lot calmer,” he says. “We were able to readjust the environment.”

Oni and staff have also “data mined” residents’ playlists to discover who have similar interests, to create small music appreciation groups. Staff play shared musical favorites on speakers, as well as music videos on a big screen. Not only did a group of country music lovers enjoy seeing and hearing Loretta Lynn on a YouTube video; the music formed the basis for creating a support group.

Hoping to ease residents out of their isolation, Oni has purchased splitters to encourage sharing. “I teach volunteers and spouses to listen together when they visit residents. Hit pause and discuss what you’ve both heard and the associated memories.”

Crucial Support from Veterans Groups

Fellow veterans have been an important source of support for the Idaho State Veterans Home. Speaking to a group of POW-MIA bikers, whose motto was “No Vets Left Behind,” Oni explained how Music & Memory can help to relieve the endemic boredom of nursing home life for vets who spend a lot of time alone between visits. “They raised and donated $10,000,” he says, enough to purchase 90 iPods, more than 100 headphones, and iTunes cards worth $500.

Anne Johnson envisions Music & Memory as the perfect vehicle for bringing together younger and older vets. “It’s such a great, feel-good program,” she says. “I would love to see younger vets creating playlists for older vets. That would be so much fun!”

Patience and Persistence Pay Off

While it takes patience and persistence to start a Music & Memory program within the inevitable bureaucracy of state and federal veterans facilities, Anne says the effort is well worth it. “We spoke with a number of VA’s to discover the lessons they learned,” she says. “Don’t be afraid of obstacles. It took us a good year to establish our program.

“I love helping people have an experience that’s not about being sick,” she adds. “This gives you the opportunity to talk about a time when the person was young, before he was confronted with so many health issues. That’s something powerful.”

Oni Kinberg agrees. “Music & Memory gives you an avenue for creating a personal connection. It serves as a backdoor to person-centered care.” he says. “Music is part of who we are. Everyone can relate.”

Founded in 2010, MUSIC & MEMORY® is a non-profit organization that brings personalized music into the lives of people with cognitive or physical conditions through digital music technology, vastly improving quality of life.

A chain reaction—that’s how one person’s joy, listening to musical favorites, can spread to people nearby. For those in the front lines of nursing home care, that positive energy can be transformative.

“When a resident puts those headphones on, there’s life,” says Olivia Emiko Thompson, a Certified Nursing Assistant (CNA) at MorseLife Health System in West Palm Beach, Florida. “They see you, they smile. The ones who can’t do ADLs (activities of daily living) for themselves are up and dancing.

“It’s a hard job in a long-term care residence,” she continues. “You’re amazed by the effects on residents. They’re happy and have a better quality of life. I’m inspired because it reminds me of why I do what I do.”

CNAs Play a Key Role in Making MUSIC & MEMORY® a Success

Close daily contact with residents place CNAs at the heart of a team effort to create a successful Music & Memory program. Not only do they witness the immediate benefits of personalized music, but also can play a key role in helping to identify which songs have the most positive impact. In addition, CNAs can observe and report when a resident would most benefit from listening to musical favorites—to help ease transitions, for example, or make dressing or bathing a more soothing activity.

MorseLife has been offering Music & Memory to residents for nearly three years. Emiko Thompson says she sees the positive effects throughout the day. A silent, isolated woman sings and kisses her husband and converses when they share her musical favorites. A 100-plus-year-old woman, whose daughter was heartbroken to have made the decision to place her in a nursing home, claps and hugs when she hears her beloved Yiddish music. “You should have seen the look on her daughter’s face,” says Emiko Thompson. “It not only helps the resident. It also helps the family and helps me and other team members. It gives you hope.”

Personalized Playlists Improve Lives of Residents and Their CNAs

Robert Holway, Therapeutic Recreation Coordinator at MorseLife, agrees that personalized playlists improve the lives of both residents and the CNAs who care for them. “It’s a cascading effect,” he says. “Everything for the CNAs goes better. The residents are happier, easier to work with. It’s a more friendly, welcoming environment. The CNAs will engage with the residents in a different way. A resident may be enjoying the music and doing a little chair dance. The CNA will join in and engage with them. Sometimes you’ll get a whole roomful of people joining in and sharing the excitement. It’s a beautiful thing to see.”

A personalized playlist can also be a magnet for community. A resident with ALS, who couldn’t use her extremities and was confined to her bed and wheelchair, became the center of attention when Holway set her up with a playlist and an Amazon Echo that enabled her to use voice commands to listen to her favorite music and other media.

“I follow up and she says all the CNAs seem to be attracted to her room. They hang out, have a little piece of candy, enjoy the ambiance,” he says. “It’s like having a bouquet of flowers, a positive aroma. She knows the different CNAs and the music they like. They have a party in there.”

MUSIC & MEMORY® Inspires Other Ways to Enhance the Nursing Home Environment

Holway has used the Music & Memory personalized playlist program as a jumping off point for other creative ways to enhance the environment with preferred music. He’s designed playlists for all the dining areas based on surveying residents about what they would like to hear. “They’ve designed their own playlists,” he says. “Breakfast music is more upbeat, lunch has more easy listening, and dinner is mellower, with calming, classical music.”

In addition, he has created custom playlists for activities staff, religious services and common areas. The results are tangible: residents are more engaged, staff more productive and families appreciative about the positive atmosphere.

“From my perspective, Music & Memory has provided the seed. From there, who knows what can happen. It’s limitless,” says Holway. “The beautiful thing about Music & Memory is the engagement. The music is the tool. It begins with a conversation: What’s your favorite music? That opens up the reminiscences, and from there it flows. It’s almost like we have to get out of the way and let it organize us and see how it unfolds.”

Founded in 2010, MUSIC & MEMORY® is a non-profit organization that brings personalized music into the lives of people with cognitive or physical conditions through digital music technology, vastly improving quality of life.

The 95-year-old resident of the Memory Care unit at Mary, Queen of Angels Assisted Living Community in Nashville, Tenn., is one of those people who makes an indelible impression as soon as you meet her. The fourth child of eight, Jo grew up on a farm. “She was the best cotton picker and hoer. Her dad was real proud of her,” says Marie, who has spent many hours getting to know Jo in the process of creating her personalized playlist.

“I Get to Be Me”

“Jo is absolutely magic. She’s this neat person, very gentle. When others are anxious, she’ll talk them down. She likes to move, put on the iPod and walk laps in the unit. I’ve never seen her with high anxiety or low depression. She can’t always give you the answer to basic questions, but a lot of her is still present.”

When Marie asks where she goes in her mind when listening to her music, Jo responds, “Well, mostly looking for my husband,” the love of her life. And at the end of every MUSIC & MEMORY® session, she’ll say, “Thank you so much for the music. It’s like I get to be me.”

“Music takes her to a place where she can connect with her true essence,” says Marie.

“I’ve Got to Do This”

Experiences like her relationship with Jo continually inspire Marie to put in hundreds of volunteer hours at Mary, Queen of Angels. A former oncology nurse, she retired a few years early to care for her own 93-year-old mother. “She’s very much alive and clear, but physically needs more support to have full and stimulating days,” says Marie. “I have, for the time being, left the work force to be 100 percent available to her.” It was during this time that she first became interested in Music & Memory after watching a screening of Alive Inside. Deeply moved by the impact of the personalized playlist program, she decided, “in that one moment, I have to do this.”

Volunteering as a Music & Memory Ambassador, she began calling area memory care units and delivering more than 100 copies of the documentary, which she purchased herself, all over town. About two months after she had spoken with staff at Mary, Queen of Angels, Marie got a call to meet with Executive Director Lyndsey Gower. By the end of the meeting, Music & Memory was a go. Once staff and Marie completed certification training, the memory care unit launched the Music & Memory program, with Marie as lead volunteer. Gower and Activities Director Tammy Marlin have been very supportive of the program.

Now, a year in, Marie says all 18 residents of the Memory Care Unit have iPods. She manages the playlists with the help of Life Enrichment Assistant Carol Azmita and brings the music to the residents. “One day, one of my sweeties was having a meltdown,” she recalls. “I said, ‘Meg, let’s rock and roll!’ and set her up with her iPod. She still had little tears in her eyes, but within seconds, she was singing and swaying her hips to Jerry Lee Lewis’s Great Balls of Fire. To use such a therapeutic modality is mind blowing.”

“We Have Residents Dancing in the Hallways”

Nurses in the unit are beginning to notice. “At first, they thought this is just one more thing to do,” says Marie. “But we have residents dancing in the hallway. They are realizing there really is something to this.”

For Marie, there’s no question that Music & Memory is a powerful way to uplift the residents, tap into lost memories and build meaningful relationships. “I’m passionate about health and much prefer music over psychotropic meds,” she says. “This is just so powerful. I’m determined, in my own little way, to keep putting it out there and convincing other interested caregivers to try it.

“Music is the best medicine I have ever administered.”

Founded in 2010, MUSIC & MEMORY® is a non-profit organization that brings personalized music into the lives of people with cognitive or physical conditions through digital music technology, vastly improving quality of life.